In addition to having a 10-member board drawn from practicing physicians, Kasper says DuPage has a "sustainable ownership model" that encourages physicians to invest in their practices. DuPage gives member practices a measure of independence, he says. "The physicians have autonomy over their own schedules, practice approach, and philosophies."
DuPage’s consolidation strategy has believers in the financial world, too. In December 2015, the physician organization secured a $250 million investment from Boston-based Summit Partners, a global growth equity firm.
At Kaufman Hall, Kamholz is bullish on DuPage’s odds for consolidation activity and growth success. "They are taking private equity investment to get bigger and stronger to make the investments necessary to be successful in the new environment. They have a high degree of confidence in their strategic direction, they have strong financial performance, and they have a balance sheet that helps them withstand some of the pressures that they are facing."
Last year, DuPage demonstrated strong growth, adding 211 providers and 16 locations in DuPage, Kane, Kendall, Will, Cook, and Grundy counties.
Despite the apparent success DuPage is enjoying in northern Illinois, the future survival scenarios for many physician practices across the country are far less rosy.
Given the trends identified in the PAI acquisitions study, physician practices and the doctors who work in them are facing daunting challenges, Seligson says.
"There is a sense of a need to provide better outcomes and to work collaboratively. Physicians are obviously at the forefront of providing the care. In order for value-based care to really work, doctors have to be at the forefront and have the autonomy and the ability to make good clinical decisions in a collaborative way—whether it is in an outpatient setting, working in a hospital setting, or working with other providers to make sure a patient’s care is the appropriate care when he or she needs it."
Health systems acquiring independent physician practices is often at odds with the adoption of value-based care models, Seligson says. "We feel that sometimes the big systems are not really conducive to value-based care, which needs to be more of a collaborative effort. A lot of the hospital CEOs say there is a strong need for the private practice of medicine to support what they are doing to deliver value-based care."
When health systems and hospitals pursue consolidation strategies with much more than the financial bottom line in mind, MAP transactions generate value for all of the stakeholders involved—including patients in the form of better care coordination, Louge and Kitchell say.
Christopher Cheney is the senior clinical care editor at HealthLeaders.